Spirit Day

All fields marked with an asterisk (*) are required.

required text field

Child’s Name*

required text field

Child’s Age*

required text field

Child’s Grade*

required checkbox field

Shirt Size*

Adult X-Small

Adult Small

Adult Medium

Adult Large

Adult X-Large

Adult 2X-Large

required email address field

Parent’s Email Address*

required text field

Parent’s Phone Number*

required text field

Emergency Contact Name*

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Emergency Contact Phone Number*

required textarea field

Child’s Allergies*

required radio button field

Date Your Child Will Attend*

January 27, 2024

required radio button field

By selecting the option below, you are indicating you are aware of the $30 cost associated with the clinic. Payment can be processed using the Pay Now option on the main clinic page.*

I agree

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